血浆microRNA-214在AMI患者中的表达及其与左室重构的关系  

Expression of plasma micro RNA-214 in patients with acute myocardial infarction and its correlation with left ventricular remodeling

作　　者：肖亚利[1] 赵敏[1] 吕平[1] 刘瑞娟[1] 王金艳[1] 崔涛[1] XIAO Ya-li;ZHAO Min;LYU Ping;LIU Rui-juan;WANG Jin-yan;CUI Tao(Department of Cardiology, Hebei Province Zhuozhou City Hospital, Zhuozhou 072750, China)

机构地区：[1]河北省涿州市医院心内科,072750

出　　处：《天津医药》2017年第5期501-505,共5页Tianjin Medical Journal

基　　金：保定市科学计划与发展指导计划项目(15ZF058)

摘　　要：目的探讨血浆微小RNA(microRNA)-214在急性心肌梗死(AMI)中的表达及其与左室重构(LVR)的关系。方法选取AMI患者158例和正常对照组85例。根据经皮冠状动脉介入术(PCI)术后是否发生左室重构,将AMI患者分为LVR组41例和非LVR组105例。荧光定量反转录-聚合酶链反应(qRT-PCR)检测血浆microRNA-214含量,免疫法检测脑钠肽(BNP)及C反应蛋白(CRP)水平。Pearson相关分析LVR患者血浆microRNA-214水平与BNP、CRP的相关性。应用受试者工作特征(ROC)曲线评价血浆microRNA-214、BNP及CRP对AMI患者PCI术后发生LVR的诊断价值,Logistic回归模型分析上述指标与LVR的关系。结果与对照组比较,LVR组和非LVR组左室射血分数(LVEF)、左室短轴缩短率(FS)均明显下降,且LVR组较非LVR组下降更明显(均P<0.05);而LVR组和非LVR组左室舒张末期内径(LVDD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)均明显升高,且LVR组较非LVR组升高更明显(均P<0.05)。LVR组血浆microRNA-214、BNP及CRP水平均明显高于非LVR组和对照组(均P<0.05)。相关分析显示,LVR患者血浆microRNA-214与BNP、CRP均呈正相关(r分别为0.684和0.402,均P<0.01)。血浆microRNA-214、BNP预测AMI患者发生LVR的ROC曲线下面积(AUC)及95%CI分别为0.824(0.757~1.015)和0.785(0.721~0.864),均高于CRP[0.716(0.645~0.837)](P=0.0167)。血浆microRNA-214预测AMI患者发生LVR的敏感度和特异度最高,分别为72.6%和86.2%。Logistic回归模型分析显示,血浆microRNA-214及BNP水平升高为发生LVR的危险因素。结论血浆microRNA-214在LVR患者中高表达,有望作为预测AMI患者PCI术后发生LVR的生物学指标。Objective To investigate the expression of plasma microRNA-214in patients with acute myocardial infarction(AMI)and its correlation with left ventricular remodeling(LVR).Methods A total of158AMI patients and85controls were selected from Hebei province Zhuozhou City Hospital.According to the left ventricular remodeling after PCIoperation,AMI patients were divided into LVR group(n=41)and non LVR group(n=105).Real-time quantitative reversetranscription-polymerase chain reaction(RT-PCR)was used to detect the plasma microRNA-214levels,and the brainnatriuretic peptide(BNP)and C-reactive protein(CRP)levels were detected by immunoassay.Pearson correlation analysis ofplasma microRNA-214levels and the correlation between CRP and BNP were analyzed in patients with LVR.The receiveroperating characteristic(ROC)curve analysis of plasma microRNA-214,BNP and CRP were used to predict the efficacy ofLVR in patients with AMI after PCI.Logistic regression model was used to analyze the relationship between the aboveindexes and LVR.Results Compared with the control group,left ventricular ejection fraction(LVEF)and left ventricularshort axis shortening(FS)were significantly decreased in LVR group and non LVR group,and which were decreased moresignificantly in LVR group compared with those of non LVR group(P<0.05).The left ventricular end diastolic diameter(LVDD),left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)were significantlyincreased in LVR group and non LVR group,and which were increased more significantly in LVR group than those in nonLVR group(P<0.05).The levels of plasma microRNA-214,BNP and CRP were significantly higher in LVR group thanthose in non LVR group and control group(P<0.05).Correlation analysis showed that microRNA-214,BNP and CRP werepositively correlated in patients with LVR(r=0.684and r=0.405,P<0.01).The area under ROC curve(AUC)and95%CIpredicted by plasma microRNA-214and BNP were0.824(0.757-1.015)and0.785(0.721-0.864)in patients with AMI andLVR,which were higher than CRP[

关 键 词：心肌梗死 心室重构 细小RNA病毒科 敏感性与特异性 microRNA-214 

分 类 号：R542.22[医药卫生—心血管疾病]